RESUMO
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract whose etiology is unknown, which can transmurally affect any segment of the intestine and/or the perineal region. Worldwide, the incidence of inflammatory bowel disease has increased in recent decades, and the same upward trend can be seen in South America. At national level, there are no official data, however, the increase in the number of publications in the last 20 years confirms this upward trend. Crohn's disease is a forgotten disease and does not have implemented clinical guidelines based on evidence that contribute to clinicians in decision making. In this sense, the Peruvian Association for the Study of the Intestine considers the preparation of this document relevant and timely. clinical contextualized for Peru.
Assuntos
Doença de Crohn , Humanos , Doença de Crohn/terapia , Doença de Crohn/diagnóstico , PeruRESUMO
Presentamos la historia clínica de un paciente de 52 años, portador de Enfermedad de von Willebrand, hospitalizado por un cuadro de hemorragia digestiva baja, que cedió espontáneamente. En la colonoscopia se detectó en sigmoides una lesión elevada grande con pedículo grueso. Tres horas antes de la polipectomía se le transfundió 6 unidades de crioprecipitado, además recibió ácido tranexámico por vía oral; por seguridad se decidió usar un minilazo (endo-loop) oval denylon, que se ajustó en la base del pedículo, y por encima se realizó el corte con asa de alambre y equipo de electrocoagulación. La evolución fue buena, no presentó ninguna complicación.
We report a 52 year-old man with von Willebrand disease and lower digestive hemorrhage secondary to large pedunculated polyp in the sigmoid color. He gave tranexamic acid and transfusion of 6 units of cryoprecipitate three hours before the polypectomy. We used a detachable snare (nylon end-loop) that allowed endoscopic ligation of the stalk of a large pedunculated polyp. A diathermic snare was then used to sever the stalk of the polyp above the tightened loop. No bleeding occurred during or after proceeding. The mini-detachable snare is a device that provides safe and effective hemostasis during removal of large polyps.
Assuntos
Masculino , Humanos , Pessoa de Meia-Idade , Doenças de von Willebrand/complicações , Pólipos/diagnósticoRESUMO
Los melanomas metástasicos al tracto gastrointestinal son usualmente comunes dentro la patología de metástasis gastrointestinal, siendo el intestino delgado el lugar más común. La aparición de melanoma primario del intestino delgado es rara. Nosotros describimos un caso de melanoma primario en la ampolla de Vater y los criterios de diferencia entre primario y metastásico en el intestino delgado.
Metastatic melanomas to the gastrointestinal tract are common, with the small intestine representing the most common site of gastrointestinal metastases. The occurrence of primary melanoma of the small intestine, however, is rare. We describe a case of primary melanoma of the ampulla of Vater and established criteria for distinction between primary and metastatic small intestinal melanoma.